Strategic approach to concurrent aberrant left gastric vein and aberrant left hepatic artery in laparoscopic distal gastrectomy for early gastric cancer: A case report

• Published in: Asian journal of endoscopic surgery Vol. 8; no. 4; pp. 454 - 456
• Main Authors: Kuwada, Kazuya, Kuroda, Shinji, Kikuchi, Satoru, Hori, Naoto, Kubota, Tetsushi, Nishizaki, Masahiko, Kagawa, Shunsuke, Fujiwara, Toshiyoshi
• Format: Journal Article
• Language: English
• Published: Japan Wiley Subscription Services, Inc 01-11-2015; John Wiley and Sons Inc
• Subjects: Aberrant left gastric vein; aberrant left hepatic artery; Carcinoma, Signet Ring Cell - surgery; Case Report; Case Reports; Female; Gastrectomy; Gastric cancer; Hepatic Artery - abnormalities; Hepatic Artery - surgery; Humans; laparoscopic gastrectomy; Laparoscopy; Middle Aged; Portal Vein - abnormalities; Portal Vein - surgery; Stomach Neoplasms - surgery; Veins & arteries; laparoscopic gastrectomy; Aberrant left gastric vein; aberrant left hepatic artery
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12203

An aberrant left gastric vein (ALGV) directly entering the lateral segment of the liver is a rare variation in the portal vein system, whereas an aberrant left hepatic artery (ALHA) arising from the left gastric artery is observed relatively frequently. Here we report a case in which both ALGV and ALHA were encountered before laparoscopic distal gastrectomy with curative lymphadenectomy for gastric cancer. We accurately diagnosed these vessel anomalies preoperatively on abdominal contrast‐enhanced CT. During surgery, we divided the ALGV at the point of entry to the liver and preserved the ALHA by dividing the branches toward the stomach, in consideration of curability and safety. The postoperative course was uneventful overall, although temporary mild liver dysfunction was observed. This case highlights the importance of preoperative evaluation and preparation in a rare case of concurrent ALGV and ALHA.